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Articles by T Kerr
Total Records ( 2 ) for T Kerr
  K Shannon , T Kerr , B Marshall , K Li , R Zhang , S. A Strathdee , M. W Tyndall , J. G. S Montaner and E. Wood
 

Objective  To examine whether there were differential rates of hepatitis C virus (HCV) incidence in injecting drug–using youths who did and did not report involvement in survival sex work.

Design  Data were derived from 2 prospective cohort studies of injecting drug users (May 1, 1996, to July 31, 2007). Analyses were restricted to HCV antibody–negative youths who completed baseline and at least 1 follow-up assessment.

Setting  Vancouver, British Columbia, Canada.

Participants  Of 3074 injecting drug users, 364 (11.8%) were youths (aged 14-24 years) with a median age of 21.3 years and a duration of injecting drug use of 3 years.

Main Exposure  Survival sex work involvement.

Main Outcome Measure  The Kaplan-Meier method and Cox proportional hazards regression were used to compare HCV incidence among youths who did and did not report survival sex work.

Results  Baseline HCV prevalence was 51%, with youths involved in survival sex work significantly more likely to be HCV antibody positive (60% vs 44%; P = .002). In baseline HCV antibody–negative youths, the cumulative HCV incidence at 36 months was significantly higher in those involved in survival sex work (68.4% vs 38.8%; P < .001). The HCV incidence density was 36.8 (95% confidence interval [CI], 24.2-53.5) per 100 person-years in youths reporting survival sex work involvement at baseline compared with 14.1 (9.4-20.3) per 100 person-years in youths not reporting survival sex work. In multivariate Cox proportional hazards analyses, survival sex work was the strongest predictor of elevated HCV incidence (adjusted relative hazard, 2.30; 95% CI, 1.27-4.15).

Conclusion  This study calls attention to the critical need for evidence-based social and structural HCV prevention efforts that target youths engaged in survival sex work.
  M. J. S Milloy , T Kerr , R Zhang , M Tyndall , J Montaner and E. Wood
  Background

Treatment for drug addiction is effective in reducing the harms of injection drug use, including infection with HIV and/or hepatitis C. We sought to examine the prevalence and correlates of being unable to access addiction treatment in a representative sample of injection drug users randomly recruited from a supervised injection facility.

 Methods

Using generalized estimating equations, we determined the prevalence and factors associated with being unable to access addiction treatment.

 Results

Between 1 July 2004 and 30 June 2006, 889 individuals completed at least one interview and were included in this analysis. At each interview, ~20% of respondents reported trying but being unable to access any type of drug or alcohol treatment in the previous 6 months. Being unable to access treatment was independently associated with recent incarceration, daily use of heroin and borrowing used syringes. In a secondary question, the majority of individuals reported waiting lists were the reason for being unable to access treatment.

 Conclusion

Given the independent association between inability to access addiction treatment and elevated HIV risk behavior, these results suggest expanding addiction treatment may contribute significantly to HIV prevention efforts in this population.
 
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